NICE advises immediate referral for suspected childhood diabetes

The National Institute for Health and Care Excellence is advising that children and young people with suspected diabetes be seen by a specialist immediately.

The Institute has now published a new quality standard which stresses that immediate referrals are a key part of diagnosing and managing both type I and type II diabetes in the young.

"Prompt diagnosis is vital because diabetes is a long-term condition that has a serious impact on people who live with it," NICE said, stressing that, if left untreated, it can cause tissue damage, resulting in blindness, kidney failure, foot ulcers which can lead to amputation, and also premature heart disease, stroke and death.

The standard also advises that children and young people with type I diabetes should be offered intensive insulin therapy to help them maintain near normal blood glucose levels, and that diabetes management should include education, support and access to psychological services.

"We know that reaching and maintaining near normal blood glucose levels is difficult, but it reduces the tissue damage caused by high blood glucose, and so may avoid the long-term health problems caused by diabetes," said Professor Gill Leng, deputy chief executive of NICE.

"Diabetes teams should provide all the help that children and young people need to stay as healthy as possible, including psychological support through access to mental health professionals with an understanding of diabetes."

Dr Stephen Lawrence, Diabetes Lead at the Royal College of General Practitioners, says "the aspirations from NICE are admirable, and a welcome addition to existing guidance - particularly for type 1 diabetes, having our patients that we suspect of having diabetes in front of a specialist within 24 hours is something that the College has called for".

But he also stressed that general practice and subsequent services are resourced sufficiently in order for the new NICE recommendations to become a reality. "We also need better joined up working across the health service, so that specialist services don't become overloaded with any increase in demand, and that GPs don't bear the brunt of criticism for simply following clinical guidance in the best interests of our patients."